Sunday, January 16, 2011

Let's Hear it for the Boys!

Bryce in his natural habitat...
As hard as women have it in the infertility world, I've been thinking that it may actually be harder for the guys. Ok, all of you who have been through the workups and procedures and injections and are screaming, "WHAT!!! No way do they have it harder!" -- hear me out. It is the woman who just about everything happens to. The woman has the bulk of the highly invasive testing. The woman takes all the drugs for the most part (although I have heard of men taking Clomid and Bryce did take a herbal supplement to improve numbers). The woman is constantly in the doctor's office for ultrasounds and blood draws and has her feet up in the stirrups and only a shred of dignity left after a cycle or two, much less years of these shenanigans. The woman has to feel every possible symptom of early pregnancy and interpret however until blood test results on the woman's phone are called in. A guy has to... get intimate with a cup.

But is that really it? I don't think so. I've been honestly thinking hard about the male perspective ever since I made a simple semantic mistake when talking about our cycle a month or so ago. I was talking about the disappointing embryo turnout in our last cycle, and I kept saying "MY embryos." Bryce very quietly stopped me at one point and said, "They're not YOUR embryos. They're OUR embryos. I think sometimes you forget that." I felt awful. I felt humbled. It is so easy to make this whole process all about me--my eggs, my hormone levels, my retrieval, my physical discomfort, my emotional why not call them my embryos? And then I thought about it. How it must be to be such an integral part of this process--you can't have embryos without the sperm to fertilize them--and to have to stand at the sidelines for so much of it.

I have asked Bryce many times how he is feeling during a cycle, and more often than not I get this response: "It doesn't matter how I feel. I'm too busy worrying about how you feel to even consider how I'm feeling. What matters is supporting you and making sure that you feel ok." Which is very noble, but a little misguided. I don't doubt that Bryce feels as much excitement, trepidation, and sadness as I do throughout the course of a cycle. There is a lot of pressure put on his contribution--if I work hard all cycle to produce some good eggs and then the sperm doesn't do the trick, then how must that feel? Not so great, I bet. When we started this process we were under the impression that it was just male factor fertility that we were facing. That was our known variable. I knew that male factor was an issue and we would face this difficulty from the beginning of our relationship--Bryce was very open and clear from just about the first month of dating that he had previously been down the infertility path and likely at some point if we had a future together, we would too. I had an out--as if I would have EVER taken it. That's actually what made me realize I was falling in love with Bryce--that I have always wanted children very badly and even knowing that that would be difficult or impossible to achieve traditionally with this person I didn't know very well at that point, I didn't care. I wanted Bryce, whether we could easily have kids at some point or not. So, when it finally came time to go start this process, I knew that it would be at least a little hard. Bryce felt terrible, like it was all his fault that we had to see doctors instead of getting busy at specific times. He held the majority of the burden. Until it became clear that I had ovulatory dysfunction and PCOS and held part of the difficulty, too. For us, that was almost a freeing experience. We were equal partners again--Bryce could stop feeling guilty for the male factor because I was also faulty. It balanced out the guilt. Sort of.

The guilt resurfaced when we did injectible IUIs and the clinic finally had the magic potion that could make me produce mature follicles and ovulate. Not spectacularly, but sufficiently. That unevened the playing field, because now I had the means to get my eggs all ready for insemination, but then the sperm still had to make the (albeit a much shorter) trip. The best of the best were selected and then concentrated and then they had to swim from the top of my uterus up the tube to fertilize the egg(s) that were coming down the hatch. And then they had to fertilize it. Which just didn't happen. That must have been difficult, because I worked really hard for those eggs and then the sperm couldn't do their part. It made Bryce feel horrible, like he failed me at the crucial moment. Even though we were told that we were very, very poor candidates for IUI and it wouldn't likely work anyway, each negative was a guilt-ridden blow to Bryce. Nothing I could say would make him feel better--it was almost like he felt sole responsibility for our continued failure.

Quarter for perspective on needle size.

Moving on to IVF, Bryce's physical role shrank even more. He still provided his sample at the crucial moment. A much more high-pressure moment as they come get him to go into the porn palace as they are setting up my IV and he has to be done before I go in for egg retrieval so that they can properly prepare and select the individual sperm. But throughout the cycle, he stood by and supported me while my body and mind were assaulted by the various medications; while I cried because I had no pants that fit my new, bloated, follicle-ridden belly; while I went in for uncomfortable ultrasound after uncomfortable ultrasound. During this IVF cycle Bryce was actually able to come to all of my appointments with me, which was a great comfort. He took care of me after the procedures. But his physical part was very small--he didn't have to take the supplement anymore because for IVF you only end up with as many sperm as you have eggs to fertilize, so 100,000 is the magic minimal number per sample. They hand-picked the best sperm and then injected them into the eggs. They didn't have to swim, they didn't have to penetrate the egg's shell, they only needed to meld nucleus to nucleus once inside to fertilize the egg. Bryce has a very important duty now though--he is the wielder of the intramuscular progesterone injection. He prepares the syringes and the swabs and gauze pads and other accoutrements. I ice my hip/upper butt and then the whole nasty 1.5 inch needle business is all Bryce--and he is fabulous at it. It has yet to hurt even though it is a big honking needle going into a tender area every morning. He has a system, and is super efficient. I don't even have to look at that nasty needle. He is the injection master.

In a physical sense, Bryce's role is technically very small. He doesn't have to go to appointments except when, um, producing. But Bryce's emotional role is huge. He supports. He makes me laugh when I am sad for no reason or good reasons. He puts things into perspective. He maddeningly creates algorithms for our actual success probability on each attempt, which makes me roll my eyes but I love it. He hugs and microwaves my butt heater and brings me tea and figures out how to dart that giant needle as painlessly as possible. It must be exhausting to be so supportive when you have just as much at stake as "the carrier." It must be really, really hard to watch your wife go through every discomfort and know that there is ultimately nothing that you can do to make it right. We are playing with the cards we were dealt, and there's really no further way to stack our deck. There must be an overwhelming sense of responsibility and obligation--not in a bad way, but a feeling that somehow he has to be a rock for me and not show any sense of emotional distress himself. The sense of providing--of making sure that we have the money to do this and worrying about coming up with more money if it doesn't. The sense that we have spent so much money on this process that our savings are pretty much dumped into the Babymaking Fund and there's nothing left for the Baby Fund. It just must be so overwhelming and lonely to be a man in this process, when everything is so centered on the woman's experience. There is a support group that men are welcome to attend at my clinic, but I have never seen a man actually attend in the past year. Not once. I haven't even heard of a support group for men. Maybe because that sense of pride and responsibility and rock-ness makes the idea of going to a support group unattractive. Men aren't supposed to need support, they're supposed to BE support. It sounds miserable to me.

I am incredibly appreciative of everything that Bryce does in the course of a cycle and when we're between cycles--he is an amazing support and partner through this process that really marginalizes the man's role. Not on purpose, it's just logistically the case. Everything is in my name, because I am the host. I wish that it was somehow more even so that the burden of appearing (but certainly not being) emotionless didn't rest on Bryce. I know that he is just as scared as I am that we are not actually pregnant. I know that he is scared that we are pregnant, but that it won't last. I know that he is scared of what the future would bring if we just can't get the stars to align and a baby to result from all our massive efforts. I know that he feels a sense of responsibility for us being in this position to begin with--because I can be made to ovulate but if sperm are defective the only option is to use donor sperm or abandon the biological child quest. I know that the prospect of the donor sperm question weighs heavily and is a highly emotionally fraught issue, just as the prospect of donor eggs would be for me. I know that if we are pregnant, I will be 98% jubilant and Bryce will be at least 70% terrified of everything that could go wrong and how he can support me through that. I've said I'll be happy when we're past the first trimester, then I can relax a bit. Bryce has said he'll be happy when there's a baby in our arms and then he can sort of relax. It is a tremendous burden.

For all the men going through infertility out there, I salute you. You have a tough job, if not physically then emotionally. Thank you for being an amazing support system. Just remember, us ladies are tough cookies--we can go through all the physical and emotional wreckage and still support you when you need it.

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